Genetic deletion of Sost or pharmacological inhibition of sclerostin prevent multiple myeloma-induced bone disease without affecting tumor growth

Leukemia. 2017 Dec;31(12):2686-2694. doi: 10.1038/leu.2017.152. Epub 2017 May 22.

Abstract

Multiple myeloma (MM) causes lytic bone lesions due to increased bone resorption and concomitant marked suppression of bone formation. Sclerostin (Scl), an osteocyte-derived inhibitor of Wnt/β-catenin signaling, is elevated in MM patient sera and increased in osteocytes in MM-bearing mice. We show here that genetic deletion of Sost, the gene encoding Scl, prevented MM-induced bone disease in an immune-deficient mouse model of early MM, and that administration of anti-Scl antibody (Scl-Ab) increased bone mass and decreases osteolysis in immune-competent mice with established MM. Sost/Scl inhibition increased osteoblast numbers, stimulated new bone formation and decreased osteoclast number in MM-colonized bone. Further, Sost/Scl inhibition did not affect tumor growth in vivo or anti-myeloma drug efficacy in vitro. These results identify the osteocyte as a major contributor to the deleterious effects of MM in bone and osteocyte-derived Scl as a promising target for the treatment of established MM-induced bone disease. Further, Scl did not interfere with efficacy of chemotherapy for MM, suggesting that combined treatment with anti-myeloma drugs and Scl-Ab should effectively control MM growth and bone disease, providing new avenues to effectively control MM and bone disease in patients with active MM.

MeSH terms

  • Adaptor Proteins, Signal Transducing
  • Animals
  • Antibodies, Monoclonal / pharmacology
  • Antineoplastic Agents / pharmacology
  • Biomarkers
  • Bone Diseases / diagnosis
  • Bone Diseases / etiology*
  • Bone Diseases / prevention & control*
  • Bone Morphogenetic Proteins / antagonists & inhibitors*
  • Bone Morphogenetic Proteins / genetics*
  • Bone and Bones / drug effects
  • Bone and Bones / metabolism
  • Bone and Bones / pathology
  • Bortezomib / pharmacology
  • Cell Line, Tumor
  • Cell Survival / drug effects
  • Dexamethasone / pharmacology
  • Disease Models, Animal
  • Disease Progression
  • Gene Deletion*
  • Genetic Markers / genetics
  • Humans
  • Mice
  • Mice, Knockout
  • Multiple Myeloma / complications*
  • Multiple Myeloma / genetics*
  • Multiple Myeloma / pathology
  • Osteoblasts / drug effects
  • Osteoblasts / metabolism
  • Osteolysis

Substances

  • Adaptor Proteins, Signal Transducing
  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Biomarkers
  • Bone Morphogenetic Proteins
  • Genetic Markers
  • SOST protein, human
  • Bortezomib
  • Dexamethasone